Kutluhan Musab Ali, Özsoy Emrah, Şahin Aytaç, Ürkmez Ahmet, Topaktaş Ramazan, Toprak Tuncay, Gümrükçü Gülistan, Verit Ayhan
Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
Department of Urology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Andrology. 2021 Jan;9(1):407-413. doi: 10.1111/andr.12895. Epub 2020 Sep 10.
Platelet-rich plasma is a biological instrument rich in growth factors and cytokines.
The aim of this study was to investigate the effect of platelet-rich plasma on spermatogenesis and hormone production in an experimental testicular torsion model.
The rats were randomly divided into three groups, including six rats in each group as follows: the first group as the sham group; the second group as the ischemia/reperfusion + Saline group and the third group as the ischemia/reperfusion + platelet-rich plasma group. The left testicles of the ischemia/reperfusion + Saline and ischemia/reperfusion + platelet-rich plasma group were kept in four-hour torsion. Then, the left testicles of ischemia/reperfusion + Saline and ischemia/reperfusion + platelet-rich plasma groups were detorsioned, and intra-testicular 1 cc saline (ischemia/reperfusion + Saline) and 1 cc platelet-rich plasma (ischemia/reperfusion + platelet-rich plasma) were injected. At one month, blood samples were taken from all groups for hormonal evaluation and left orchiectomy was performed.
The mean follicle-stimulating hormone level of ischemia/reperfusion + Saline group was significantly higher than ischemia/reperfusion + platelet-rich plasma group (7.78 ± 0.23 vs 6.18 ± 0.28 nmol/l, respectively, P = .004). The mean LH level of ischemia/reperfusion + platelet-rich plasma group was significantly lower than ischemia/reperfusion + Saline group (3.63 ± 0.28 vs 5.68 ± 0.21 nmol/l, respectively, P = .004). The mean total testosterone level of ischemia/reperfusion + platelet-rich plasma group was significantly higher than ischemia/reperfusion + Saline group (8.05 ± 0.24 vs 5.78 ± 0.23 nmol/l, respectively, P = .004). The mean Johnsen scores of ischemia/reperfusion + platelet-rich plasma group were significantly higher than ischemia/reperfusion + Saline group (5.85 ± 0.58 vs 3.93 ± 0.65, respectively, P = .004). The mean Johnsen score of the sham group was significantly higher than ischemia/reperfusion + platelet-rich plasma and ischemia/reperfusion + Saline groups (P = .003 and P = .003, respectively).
The platelet-rich plasma has beneficial effects on spermatogenesis and reproductive hormone production in testicular torsion. It is easily accessible and applicable. In the future, intra-testicular platelet-rich plasma injection may be used in testicular torsion after detorsion. However, further experimental and large-scale prospective clinical studies are needed to establish a definitive conclusion on this topic.
富血小板血浆是一种富含生长因子和细胞因子的生物制剂。
本研究旨在探讨富血小板血浆对实验性睾丸扭转模型中精子发生和激素分泌的影响。
将大鼠随机分为三组，每组6只，分组如下：第一组为假手术组；第二组为缺血/再灌注+生理盐水组；第三组为缺血/再灌注+富血小板血浆组。缺血/再灌注+生理盐水组和缺血/再灌注+富血小板血浆组的左侧睾丸进行4小时扭转。然后，对缺血/再灌注+生理盐水组和缺血/再灌注+富血小板血浆组的左侧睾丸进行复位，并分别向睾丸内注射1毫升生理盐水（缺血/再灌注+生理盐水组）和1毫升富血小板血浆（缺血/再灌注+富血小板血浆组）。1个月后，采集所有组的血样进行激素评估，并进行左侧睾丸切除术。
缺血/再灌注+生理盐水组的平均促卵泡激素水平显著高于缺血/再灌注+富血小板血浆组（分别为7.78±0.23与6.18±0.28nmol/L，P = 0.004）。缺血/再灌注+富血小板血浆组的平均黄体生成素水平显著低于缺血/再灌注+生理盐水组（分别为3.63±0.28与5.68±0.21nmol/L，P = 0.004）。缺血/再灌注+富血小板血浆组的平均总睾酮水平显著高于缺血/再灌注+生理盐水组（分别为8.05±0.24与5.78±0.23nmol/L，P = 0.004）。缺血/再灌注+富血小板血浆组的平均约翰森评分显著高于缺血/再灌注+生理盐水组（分别为5.85±0.58与3.93±0.65，P = 0.004）。假手术组的平均约翰森评分显著高于缺血/再灌注+富血小板血浆组和缺血/再灌注+生理盐水组（分别为P = 0.003和P = 0.003）。
富血小板血浆对睾丸扭转后的精子发生和生殖激素分泌具有有益作用。它易于获取和应用。未来，睾丸复位后向睾丸内注射富血小板血浆可能用于治疗睾丸扭转。然而，需要进一步的实验和大规模前瞻性临床研究来就此主题得出明确结论。
